Are Payers Ganging up on Clinical Laboratories and Pathology Groups? Is this a Trend or Simply a Sign of Tougher Financial Times?

Medical laboratories today struggle to submit clean claims and be promptly and adequately reimbursed as health insurers institute burdensome requirements and audit more labs Across the nation, clinical laboratories and anatomic pathology groups of all sizes struggle to get payment for lab test claims. Veteran lab executives say they cannot remember any time in the past when medical laboratories were challenged on the front-end with getting lab test claims paid while also dealing on the...

Palmetto, Medicare’s Biggest Carrier, Proposes to End Code Stacking for Molecular Clinical Laboratory Tests

Palmetto wants to implement two proposed local coverage determinations (LCDs) on February 27, 2012 Medicare’s biggest local carrier is ready to tackle the problems created when clinical pathology laboratories use code stacks to submit claims for genetic tests  and molecular diagnostics assays. Medical laboratories in eight states served by this Medicare carrier are worried about its two draft proposals that could cut off reimbursement for large numbers of molecular diagnostic tests (MDTs) and...

Innovations in Clinical Pathology Laboratory Management at the 2011 Executive War College in New Orleans

Record crowd of pathologists and clinical laboratory managers hear from medical lab industry leaders Dateline: New Orleans, Louisiana—Here at the 16th annual Executive War College (EWC) on laboratory and pathology management, a crowd of record size has gathered to learn the latest trends in the clinical laboratory testing marketplace, and to hear about innovations and new management breakthroughs, as shared by top-performing medical laboratories. As your Dark Daily editor, this is my first...

New Genetic Laboratory Tests Face Complicated Hurdles to Win Reimbursement

Health insurers not eager to establish coverage for new molecular diagnostic assays Navigating the pathway to successful commercialization of new genetic tests and molecular diagnostic assays has proven tricky. While scientists work quickly to bring new and better clinical laboratory testing tools to the market, health insurers work at a much slower pace to issue coverage guidelines and establish reimbursement for these new diagnostics tests. “Successfully moving a genetic test from the...
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